NHS

I sat in the Chamber listening to Andrew Lansley detailing the changes to the Coalition's health reforms with mixed emotions.

Pleased that the 'pause' has acheived a higher level of acceptance but concerned that these changes should not now derail improved patient choice, standards and efficiency.

Both Coalition parties and Labour believe the NHS needs reform. The reasons rest with the ever-increasing demands placed upon it by an increasingly elderly population, increasingly expensive drugs/procedures plus an ever-greater demand for new medical treatments.

The political battle lines have included commissioning and competition — do we retain healthcare bureaucracies for commissioning care or do we trust doctors to decide what is best for patients? Should 'qualified providers', including the private sector, provide services if they are competitive and of equal quality to the NHS?

The new proposals still envisage GP commissioning but the oversight will now include representatives of NHS providers.

The idea is that they will ensure that commissioning promotes the effective integration of healthcare provision — the danger is that allowing NHS providers a major say in who does the providing might blunt healthy competition.

The politics is ferocious. Labour accuse the Coalition of privatising the NHS, suggesting we are attacking the principle of healthcare being free —based on need not ability to pay. This is scaremongering.

On the other hand it has to be said that both Coalition parties worry about who will be credited with the changes. On this point it should be stressed that both Coalition parties signed up to the original proposals and voted the bill through at Second Reading.

The big question is will these latest changes work or will they diminish the drivers of value and quality such that the NHS will struggle to meet the demands placed upon it. Time will tell.